Background: Maternal influenza and pertussis vaccination has been proven a safe and effective strategy to reduce maternal and infant morbidity and mortality. Although recommended by the Israeli Ministry of Health, not all pregnant women receive these vaccinations.
Objective: To evaluate the vaccine coverage of maternal immunization in pregnancy for seasonal influenza and acellular pertussis and elucidate the reasons for non-vaccination among pregnant women. The secondary objective was to evaluate factors affecting vaccine uptake.
Design: A cross sectional observational study using anonymous questionnaires distributed to women in the maternity ward or pregnant woman (>37 weeks) hospitalized in the high risk ward in Assaf Harofeh Medical Center, Israel.
Results: Of 321 women approached, 313 were eligible and 290 questionnaires were retrieved (92.6%). We found a 75.9% (95% CI 0.71, 0.81) and 34.5% (95% CI 0.29, 0.40) vaccination rate for pertussis and influenza respectively. Being under-informed (24%) and concerns about vaccine efficacy (28%) were the main reasons for not vaccinating for pertussis and influenza (respectively). Academic education, belonging to certain health maintenance organizations (“Kupat Holim”) and receiving vaccine recommendations all promote vaccination uptake, whereas a higher number of prior children, season and belonging to certain religious groups all correlate with reduced vaccine uptake.
Conclusion: Although maternal vaccination of pertussis and influenza is recommended by the Israel Health Ministry, vaccine uptake is still suboptimal. The main reasons for non-adherence suggest a central role for medical staff to recommend and explain the necessity of maternal vaccination and to diminish the concerns about safety and efficacy.